The US team found the abnormal size or functioning in the left atrium may play a role in its onset - years before the loss of memory and confusion begins.
It could open the door to a screening program. Drug trials have failed to date because they are administered once the disease has already taken hold.
Atrial cardiopathy often serves as a biomarker, or predictor, of cardiovascular disease - the world's biggest killer.
Dr. Johansen said: "Dementia risk increased even among those who did not experience atrial fibrillation or stroke, two conditions known to be associated with dementia."
The left atrium is one of four chambers of the heart - receiving blood from the lungs and pumping it into the left ventricle which sends it to the rest of the body.
Shedding light on the relationship offers hope of desperately needed treatments. The number of dementia cases worldwide will triple to 150 million by 2050.
Participants were tracked for more than three decades, during which time 763 were diagnosed with dementia and 1,709 with atrial cardiopathy.
Dr. Johansen added: "Those with atrial cardiopathy appeared to be 35 percent more likely to develop dementia."
The researchers also adjusted for people who experienced atrial fibrillation (AF) which causes a very fast heart rate and stroke.
They still observed a respective 31 and 28 percent increase in dementia risk in patients with atrial cardiopathy - even after accounting for other vascular factors.
Dr. Johansen said: "It suggests a state of atrial cardiopathy leading to dementia is not a result of atrial fibrillation or stroke alone."
She added: "The results do not imply causality. They emphasize the importance of lowering vascular and heart disease risks."
Alzheimer's and other forms of dementia affect more than 920 million Britons, a figure that will rise to 2 million within the next 30 years.
With no cure in sight, there is an increasing focus on protective behaviors. Eating plenty of fresh fruit and vegetables and getting plenty of exercise, are known to be good for both body and mind.
Dr. Johansen and colleagues followed members of the ARIC (Atherosclerosis Risk in Communities) study which began in 1987 to research heart health.
Participants were aged 45 to 65 at the start. They came from North Carolina, Maryland and Mississippi and attended checkups every three years.
Resulting data including hospital records, ECG - electrocardiogram - recordings, doctor and coroner questionnaires and death certificates were gathered.
The analysis focused on those who returned for fifth, sixth and seventh clinical visits. They were evaluated for cognitive decline indicating dementia.
It involved a comprehensive battery of neuropsychological tests measuring processing speed, episodic memory, language, attention and executive function.
A spouse, adult child or close friend of a subset were also interviewed about the individual being evaluated.
A diagnosis of dementia was generated based on a computer algorithm and then confirmed by an expert.
Added Dr. Johansen: "Cardiac evaluation, including echocardiography, electrocardiography (EKG/ECG) and blood work, was conducted to assess the size and function of the left atrium of the heart to check for signs of atrial cardiopathy."
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